Delegating Care

Delegating care to various health care workers is another area where offices get into trouble because they aren’t following the regulations related to what functions a nurse practitioner or physician’s assistant are allowed to perform.

First and foremost, physicians must ensure that all members of their staff are credentialed and allowed to provide care in Massachusetts. They must also perform background checks on all staff members, compliance experts said. It’s important to know if a caregiver was under supervision in another state or asked to leave a practice because their records were bad or their judgment was at issue, DiCianni noted.

Then, physician offices must be sure they know the scope of services each caregiver is allowed to provide. “Oftentimes the nurse practitioner or physician’s assistant is providing services he is not credentialed to provide,” said Lyn Henderson, vice president of medical staff and regulatory affairs at the Needham campus of Beth Israel Deaconess Hospital and a private compliance consultant. “A lot of times these people aren’t credentialed for the insurance company, so you’re billing incorrectly because you didn’t realize they needed to sign up.”

Next: Patient Follow-up